Burns Aftercare Guidance Child Health Patient Information Leaflet
Introduction The purpose of this leaflet is to provide guidance on the aftercare of burns. Dressings Check at least daily that dressings are intact and secure. Ensure that you have extra gauze and tape to replace or repair dressings. Never remove bottom layers of dressing as this may cause bleeding and infection. If the bandage becomes soiled, do not worry. If they become wet then return to the hospital for re-dressing as soon as possible. Wet dressings encourage infection. If you notice excessive oozing or yellow offensive smelling discharge from the wound site, return to the ward or ring for advice. Dressing to Nappy Area Change nappies more frequently and clean the surrounding skin at each nappy change. If dressings become wet or soiled, remove outer layers and re-pad with sterile gauze and tape. Return to the ward if you are unhappy with your dressing. Skin Care Keep skin clean but moisturised by washing, moisturising and massaging. The scar tissue should become paler, flatter, smoother and supple, thus improving the appearance and movement of the skin and prevent spots or infection. Use a lanolin based, unscented and plain cream for moisturising and massaging e.g. Aqueous cream or E45 cream.
Apply the moisturising cream to healed areas of skin and massage the area firmly at least three times a day. Give daily baths using a mild, unperfumed bath product e.g. baby bath. Regular washing will prevent a build-up of creams and prevent spots or infection. The newly healed skin may feel " tight after bathing but this should resolve in six months or so, and moisturising the area will help. Remember: Your child will be sensitive to heat and hot water! It is normal healing process for scars to appear red and inflamed for two to three months after injury. They will gradually fade and turn pale. Itching Itching usually happens in younger scars and indicates that healing of the injured tissue is happening. This will gradually improve as the scars soften and become paler. To relieve the symptoms: Bathe in cool water. Wear cotton or polyester materials against the skin and use cotton or polyester bed linen, as itching is often worse at night. Avoid nylon or woollen garments next to the skin as they cause irritation. Give Paracetamol (Calpol) when required and as instructed on the bottle. Try a dose before bedtime. If itching persists, contact your GP and ask for some antihistamine syrup or tablet e.g. Piriton, which will relieve the problem but may cause drowsiness.
Pain When your child is discharged home, Paracetamol is the most common and safest painkiller to use. If your child is returning to the ward for a dressing, please give a dose before leaving home. If your child complains of pain despite giving regular Paracetamol, try Ibuprofen or please phone the ward for advice. Infection If your child becomes unwell and has any of the following symptoms, then please contact the Children s Emergency Department at Lister as soon as possible: A high temperature above 38 C (101º F) that is not reduced by regular Paracetamol (Calpol). Diarrhoea that becomes worse and more frequent e.g. at least two episodes per day, and stool becomes watery in large amounts. Vomiting - the child is unable to tolerate food or fluid (at least three vomits per day). Encourage small amounts of clear fluids every hour. Rash - red spots, patches or blotches over any part of the body. These may be signs that the burn has become infected and your child may need immediate treatment with antibiotics and medical supervision of the symptoms.
Diet To maintain tissue growth and repair, encourage your child to have a balanced diet with extra protein and carbohydrates to provide energy, for example: milky drinks, meat, fish, eggs, and cheese. Sunbathing Burns injured skin, especially newly healed, is sensitive to sun damage and needs protection. First year: Avoid the sunshine and keep the young scars covered with cotton clothes and protected with a total sunblock cream (+ Factor 50). Blisters may appear very quickly after only a short time in the sun. Facial burns - Wear a hat or cap for protection AND a total sunblock cream (+ Factor 50). Second year: Use a high factor cream e.g. Factor 20 and above and take care. If skin is still sensitive and starts to blister, cover up. Third year: The injured skin should be less sensitive but always apply a high factor sun protection cream and check the skin frequently.
Swimming Once the wound is fully healed swimming is a good form of physiotherapy for the burn injured child. Further Information (Please also refer to the back page) Plastics Dressing Clinic. This is in the children s Bramble ward on the Children and Adolescent Unit, Level 2, Lilac Zone at the Lister Hospital.
Questions you may like to ask:
Further information can be obtained from: NHS 111 Dial 111 Or contact your GP Bluebell Ward, Lister Hospital, Stevenage 01438 284008 Children s Day Services, Lister 01438 286315 Children s Emergency Department, Lister 01438 284333 Children s Assessment Unit, Lister 01438 284900 Urgent Care Centre, QEII Hospital 01707 247549 Welwyn Garden City Patient Advice and Liaison Service 01438 285811 The information in this leaflet was taken from www. cks.nhs.uk Date of publication: October 2010 Author: Kathy Finlay, Rabinder Sajjan Reference: CH/237L Version: 3 Review Date: March 2019 East and North Hertfordshire NHS Trust www.enherts-tr.nhs.uk You can request this information in a different format or another language.